Both birth control pills and the birth control shot are highly effective and safe methods of preventing unplanned pregnancies. That said, they’re both very different and require serious consideration before making a choice.
Gather feedback from friends and family members, research all your options as thoroughly as you can, and reach out to your doctor with any questions or concerns. It’s important that you come to a choice that feels healthy and natural for your lifestyle.
If you decide later that the option you picked isn’t right, remember that almost all forms of birth control are interchangeable. In other words, you can swap them without affecting your fertility or your risk of getting pregnant, as long as it’s done with a doctor’s supervision.
Birth control pills are a form of hormonal contraception. Many women use birth control pills to prevent pregnancy. The pill can also be used to reduce heavy periods, treat acne, and ease symptoms of certain reproductive system issues.
Birth control pills come as combination pills and progestin-only minipills. Combination pills contain two types of hormones: progestin and estrogen. Pill packs with combination pills typically contain three weeks of active pills and one week of inactive, or placebo, pills. During the week of inactive pills, you may have a period. Progestin-only pill packs usually contain 28 days of active pills. Even though there aren’t any inactive pills, you may still have a period during the fourth week of your pack.
Birth control pills work in two ways to prevent pregnancy. First, the hormones in the pill prevent the release of eggs from your ovaries (ovulation). If you don’t have any eggs, there’s nothing for sperm to fertilize.
Second, the hormones increase the buildup of mucus around the opening of the cervix. If this sticky substance grows thick enough, the sperm that do enter your body will be stopped before getting near an egg. The hormones can also thin the uterine lining. If an egg is somehow fertilized, this ensures it will be unable to attach to the lining.
According to Planned Parenthood, when taken as directed, birth control pills are 99 percent effective in preventing pregnancy. However, most women practice what’s called “typical use.” Typical use accounts for a woman missing a pill or two, being a bit late with a new pack, or some other incident that prevents her from taking the pill every day at the same time. With typical use, birth control pills are 91 percent effective.
Once you stop taking birth control pills, you may return to your typical cycle almost immediately. You may experience your first regular period in as few as two months.
The birth control shot, Depo-Provera, is a hormonal injection that prevents unplanned pregnancy for three months at a time. The hormone in this shot is progestin.
The birth control shot works similarly to the birth control pill. It prevents ovulation and increases the mucus buildup around the opening of the cervix.
According to Planned Parenthood, when you receive it as directed, the shot is 99 percent effective. To ensure optimal effectiveness, women should get the shot every three months as directed. If you have your shot on time without being late, there’s a 1 in 100 chance you’ll become pregnant during a given year.
For women who don’t take the shot exactly as prescribed — often called typical use — the efficiency rate slips to around 94 percent. Getting the injection every 12 weeks is vital to maintaining your protection against pregnancy.
The birth control shot, like birth control pills, doesn’t protect against STDs. You should still use a barrier method of protection to help prevent STDs.
After your last shot, you might not return to your regular fertility and be able to get pregnant for up to 10 months. If you’re only looking for a temporary birth control method and wish to get pregnant soon, the shot may not be right for you.
Both birth control pills and the Depo-Provera shot are very safe for most women to use. As with any medicine, these forms of birth control have effects on your body. Some of these are intended. However, some of these are unwanted side effects.
For birth control pills, side effects can include:
- breakthrough bleeding, or bleeding during active pill days
- breast tenderness
- breast sensitivity
- breast swelling
Most of these side effects will ease within the first 2 to 3 months after you begin taking the pills.
The side effects of the birth control shot can include:
- irregular periods, which are more common in the first 6 to 12 months after your first injection
- increased spotting and breakthrough bleeding
- a change in appetite
- weight gain
- a change in sexual drive and interest
- tender, sore breasts
- a headache
- mood changes
There isn’t an easy fix for any side effects you may experience because of the shot. Once the medicine is in your body, it will remain there for three months. You may experience side effects during this time or until the shot wears off completely.
Both birth control pills and the birth control shot deliver increased doses of hormones to your body. Any time your hormones are purposefully altered, you can expect to experience some side effects or symptoms related to the shift.
The hormones in birth control pills are delivered gradually on a daily basis. The level of hormones in the pills isn’t very high. Doctors and researchers have worked for decades to find the lowest doses that are effective, as well as comfortable, for women. The Depo-Provera shot, however, delivers a high dose of hormones all at once. For that reason, you may experience greater side effects immediately following the shot.
Although birth control pills and the birth control shot are very safe for most women, doctors may not prescribe them to every woman who’s seeking a birth control plan.
You shouldn’t take birth control pills if you:
- have an inherited blood clotting disorder or a history of blood clots
- experience migraine headaches with aura
- have a history of heart attack or a serious heart problem
- smoke and are over the age of 35
- have been diagnosed with lupus
- have uncontrolled diabetes or have had the condition for more than 20 years
You shouldn’t use a birth control shot if you:
- have or have had breast cancer
- take aminoglutethimide, which is a prescription medication used to treat Cushing’s syndrome
- have thinning of the bones or bone fragility
Pros of the pill
- Your side effects are less intense than with the shot.
- You can get pregnant soon after you stop taking it.
Cons of the pill
- You have to take it every day.
- With typical use, it’s slightly less effective than the shot.
Pros of the shot
- You only have to take it every three months.
- With typical use, it’s slightly more effective than the pill.
Cons of the shot
- Your side effects are more intense than with the pill.
- It takes a while for you to be able to get pregnant after you stop receiving it.
When you’re ready to make a decision about birth control, consult your doctor. Together, the two of you can weigh your options and rule out any forms of birth control that don’t suit your needs or your lifestyle. Then, you can focus your discussion on the options most appealing to you.
Here are some questions to consider:
- Do you plan to have children? If you do, how soon?
- Can you fit a daily pill into your schedule? Will you forget?
- Is this method safe given your health profile and family history?
- Are you looking for other benefits, such as fewer periods?
- Will you be paying out of pocket, or is this covered by insurance?
You don’t have to make a choice right away. Gather as much information as you feel you need.
When you’re ready, tell your doctor what you think would be best. If they agree, you can get a prescription and begin using birth control right away. If you begin taking a form of birth control and decide it’s not for you, talk with your doctor. Let them know what you do and don’t like. That way, the two of you can look for an alternative that may be better suited to your needs.